BACKGROUND: The Rugby World Cup (RWC) is one of the biggest international mega sports events in the world. This study was conducted to identify and evaluate the volume, nature, and severity of spectator medical care in the stadiums of 12 venues across Japan during RWC 2019. METHOD: This was a retrospective review of medical records from spectator medical rooms of 45 official matches of RWC 2019 between September 20 and November 2, 2019. All patients in the stadium who visited the spectator medical room and were transferred to a hospital were included. The wet bulb globe temperature (WBGT) value at the kick-off time of each match, the number of visits to the spectator medical room, and the number of transfers to a hospital were reviewed and analyzed. The patient presentation rate (PPR) was calculated per 10,000 attendees. Severity categories were defined as mild or severe. Mild cases were considered non-life threatening requiring minimal medical intervention, and severe cases required transport to a hospital. RESULT: The total number of visits to the spectator medical room was 449 with a PPR of 2.63. Most cases (91.5%) were mild in severity. The PPR was significantly higher for the matches held with a WBGT over 25 °C than for the matches under 21 °C (PPR 4.27 vs 2.04, p = 0.04). Thirty-eight cases were transferred to a hospital by ambulance; the PPR was 0.22. The most common reasons for transfer to the hospital were heat illness and fracture/dislocation, at a rate of 15.8% each. The incidence rate of cardiopulmonary arrest per 10,000 attendees was 0.0059 during RWC 2019. CONCLUSION Preparation and provision of appropriate medical service for spectators is a key factor for mass-gathering events. During RWC 2019, the majority (91.5%) of patients who sought medical attention did so for minor complaints, which were easily assessed and managed. On the other hand, a higher WBGT situation contributes significantly to an increased PPR (< 21 versus > 25, 2.04 versus 4.27, p = 0.04). Careful medical preparation, management, and development of public education programs for higher WBGT situations will be required in the future for similar international mega sports events.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ambulatory Care/statistics & numerical data* ; Anniversaries and Special Events ; Child ; Child, Preschool ; Emergency Service, Hospital/statistics & numerical data* ; Female ; Football ; Hospitalization/statistics & numerical data* ; Humans ; Infant ; Infant, Newborn ; Japan ; Male ; Mass Behavior ; Middle Aged ; Retrospective Studies ; Young Adult

Objective: The purpose of this study was to examine the effects of Coenzyme Q10 (CoQ10) supplementation on salivary secretory immunoglobulin A (SIgA) and health-related Quality of Life (QOL) in middle-aged and elderly individuals. Methods: Sixty healthy middle-aged and elderly individuals were assigned randomly to a CoQ10 supplementation group (n = 30) or a placebo supplementation group (n = 30) using a double blind method. Subjects took 150 mg CoQ10 or placebo per day for 8 weeks. Salivary SIgA secretion rate and SF-36 test (physical and mental health-related QOL) were determined before and after the intervention. Results: CoQ10 group showed that a tendency to increase of salivary SIgA secretion rate (p = 0.08), although placebo group did not show significant change. Physical health-related QOL did not significantly change in both groups. Vitality and mental health scores, which were subscale of mental health-related QOL, were significantly increased after the intervention in CoQ10 group (p < 0.05), although placebo group did not show significant change. Conclusion: 8 weeks of CoQ10 supplementation may bolster SIgA-mediated oral immunity and mental health-related QOL in middle-aged and elderly individuals.

This study examined the effects of the use of contact lenses on static and kinetic visual acuity, ocular pain, and blurred vision during a water polo match. Eleven male water polo players participated in this study, and were assigned to one of two groups: contact lens users (CL, n=5) and non-users (NCL, n=5). Both groups participated in a typical water polo match with four 7-min periods and 2-min resting intervals between the four periods. Static and kinetic visual acuity, subjective ocular pain, and blurred vision were measured before the match (pre-test), during the match (after each of four 7-min periods), and during the recovery phase at 5, 15, and 30 min after the completion of the match.Results showed that kinetic visual acuity was significantly lower for the NCL group than for CL in the 4^th period of the match. In addition, for the NCL group, kinetic visual acuity was significantly lower in the 3^rd and the 4^th periods than at the pre-test time. On the other hand, static visual acuity did not significantly differ between the two groups; but, for NCL, static visual acuity was significantly lower in the 4^th period than at the pre-test time. According to self-evaluation scores, ocular pain significantly increased in NCL compared to CL in the 3^rd and 4^th periods. Ocular pain in NCL was significantly higher between the 2^nd period and recovery phase at 5 min than at the pre-test time. Blurred vision was significantly higher in NCL than CL between the 2^nd period and recovery phase at 5 min. Blurred vision in NCL was significantly higher at the same duration than at the pre-test time.These findings indicate that the use of contact lenses may prevent ocular pain and blurred vision, maintaining both the static and kinetic visual acuity at a normal level during a water polo match. Further, the results of this study suggest that the use of contact lenses is effective for water polo players.

 Acupuncture treatment is one of the conditioning methods in the competition field. Athletes who are forced in regularly intensive training often induced deteriorating of condition. Good conditions are adjusted by interaction of immune system, nervous system and endocrine system. Neutrophils and lymphocytes which are blood components prevent infections of the human body in various ways. Intensive training causes an increase of neutrophils, a decrease of lymphocytes and a negative impact on the immune functions. It has been reported that acupuncture stimulation could be involved in the coordination of the immune system. Therefore, acupuncture treatment could be important to keep physical condition and participate physical activity according to the plan without deteriorating of condition. It may be useful not only for athletes but also for the general public who train for the purpose of health and sports enthusiasts. The purpose of this study was to examine the effect of acupuncture stimulation on fluctuation of neutrophils and lymphocytes by the transient high-intensity exercise.
Method : Twelve healthy men (23.6±O.3 yr [±SE]) participated in this study. Subjects exercised on bicycle ergometer for 60 minutes at 75% of their VO₂max. Acupuncture treatment was applied at LU6 (Kongzui), LI 4 (Hegu), ST 36 (Zusanli), and ST 6 (Jiache), for 30 min after the exercise. Blood samples were taken before exercise, immediately after exercise, hourly after exercise until 4 hours and 24 hours after exercise. Leukocyte, neutrophils, lymphocytes, Th cells and Tc cells were measured from the blood samples.
Result : The neutrophils significantly increased from Post 1h to Post 4h in the both trials (P < 0.05). However the neutrophils was significantly lower in the acupuncture group than in the control group at Post 1h and Post 3h (P < 0.05). The lymphocytes significantly increased from immediately after exercise to Post 24h in the control trial, and increased significantly only at Post 1h to Post 3h in the acupuncture trail (P<0.05). The Th cells significantly decreased from Post 1h to Post 24h in the control trial and decreased significantly only at Post 1h, 2h and 24h in the acupuncture trail (P < 0.05).
Conclusion : These results suggested that acupuncture stimulation may reduce the increase of neutrophils and the decrease of lymphocyte and Th cells caused by high-intensity exercise. These results indicated that acupuncture stimulation may promote the recovery from high-intensity exercise.

Backgrounds : The one of the leading factors of deteriorating condition is upper respiratory tract infections (URTI) in athletes. Athletes who are forced in regularly intensive training often decrease salivary secretory immunoglobulin A (SIgA) which has important role of immune function in the buccal cavity. It causes increase of morbidity risk in URTI. Acupuncture treatment is one of the conditioning methods in the competition field and mainly treated for orthopedic injuries. On the other hands, acupuncture treatment induced increase of natural healing ability which involved immune response, and prevent and treat some diseases. It has been reported acupuncture increase SIgA level. However, the relationship between time course and diagnostic of cold by the acupuncture stimulation effect is still unclear. Thus, the purpose of this measurement is to investigate the effect of acupuncture stimulation on the SIgA during training camp. Furthermore, it is important to investigate questionnaire about diagnostic of cold during and 1 week after training camp, it leads to clear the effect of acupuncture stimulation on the URTI.
Methods : Eighty subjects men who have auditory difficulties (26.7±0.9 yr[±SE]) participated in this study. The subjects were randomly assigned two groups; acupuncture group and control group. The training camp conducted 3 days and training performed 3 hours each in the morning and afternoon. Acupuncture stimulation was applied at LU 6 (Kongzui), LI 4 (Hegu), ST 36 (Zusanli), and ST 6 (Jiache), for 30 min after dinner. To measure SIgA level, saliva samples were taken 7 times; daytime and evening of first day (Day1(D), Day1(E)), morning, daytime and evening of the second day (Day2(M), Day2(D), Day2(E)), morning and daytime in the third day (Day3(M), Day3(D)). The questionnaire about diagnostic of cold was conducted Day1(D), Day2(M), Day3(M) and 1 week after training camp.
Results : The secretion rate of SIgA in the control was not significantly changed during training camp. However, the acupuncture group was significantly higher level in the Day2(M) and Day3(M) compared to the Day1(D) (P<0.05). Both control and acupuncture group was significantly higher SIgA concentration in Day2(M) and Day3(M) compared to the Day1(D) (P<0.05), but acupuncture group was significantly higher in the Day3(M) compared to the control. The frequency of diagnostic cold was 1 in the acupuncture group and 4 in the control group. Moreover, 1 week after training camp, 6 in the acupuncture group and 6 in the control.
Conclusion : Acupuncture stimulation induced significant increase SIgA level during training camp. Moreover, the diagnostic of cold was lower during training camp in the acupuncture group. Therefore, acupuncture stimulation might reduce the risk of the morbidity of the URTI.

The purpose of this study was to investigate the relation between alterations of salivary secretory immunoglobulin A (SIgA) and the occurrence of upper respiratory tract infections (URTI) in rugby football players.We examined the relationship between the onset of URTI and the daily alterations of SIgA levels in 32 male collegiate rugby football players (20.5±1.3 years) during summer training camp for 36 days.Total of 6 in 32 subjects had the appearance of URTI symptoms (18 %). SIgA secretion rate decreased significantly in the middle of training camp compared to the baseline (P＜0.05). Furthermore, SIgA secretion rate during the appearance of URTI (13.7±1.1μg/min) were significantly lower than that without symptoms (19.2±1.4 μg/min, P＜0.01). These results suggest that serial monitoring of SIgA may be useful to assess the risk status of URTI affection in athletes.

【Objective】The purpose of this study was to investigate the acute responses of adiponectin and leptin to resistance exercise in healthy elderly men. 【Methods】Eight healthy men (age, 25.5±3.3 yrs) participated in this study. They performed two trials. Trial 1 was an exercise session consisting of 5 resistance exercises at high-intensity (75% one-repetition maximum : 1 RM) with three sets of 10 repetitions. Trial 2 was a control trial at rest for the same time as trial 1. Blood samples were taken to assess adiponectin, leptin, and metabolism related substances (glucose and lipids).【Results】Leptin significantly decreased 24 h after the resistance exercise but did not change in trial 2. Blood insulin and lactate concentrations significantly increased immediately (0 min) and 30 min after the exercise. However, adiponectin, glucose and lipids were not affected. 【Conclusion】Adiponectin was not affected by resistance exercise, whereas leptin decreased 24 h after the exercise. This suggests that leptin may have quite a delayed response to high-intensity resistance exercise.

The purpose of this study was to investigate the status of contact lens use in the pool for water polo players. A total of 627 male subjects were studied : junior high school players (n=190), high school players (n=188), college players (n=121) and water polo club players (n=128).Results were summarized as follows : 1) The percentage of players using vision correction devices in daily life was 43.38%, and use of contact lenses during water polo play was 30.14% for all subjects. 2) Junior high school players using contact lenses during water polo play showed a significantly lower rate compared with other players (X²=34.38, p<.01). 3) There were a lot of users of disposable type contact lenses during water polo play. 4) Players using contact lenses during water polo play had significantly higher corneal and conjunctival damage than subjects using vision correction devices in daily life and subjects without vision correction devices (X²=13.64, p<.01).We concluded that it was a problem for junior high school players with low vision acuity during water polo play.

[Objective] This study examined the effects of resting metabolic rate (RMR), sleeping metabolic rate (SMR), and diet-induced thermogenesis (DIT) during acute weight loss in elite male wrestlers.[Methods] Subjects were elite male wrestlers (n=6), who were instructed to reduce the body weight in seven days. RMR, SMR, and DIT were measured by indirect calorimetry in normal training phase and after rapid weight loss. Body composition and energy intake were also measured.[Results] Energy intake significantly decreased in rapid weight loss phase (P<0.05). After the rapid weight reduction, percent reduction of body weight (-4.4%), fat mass (-17.5%), and total body water (-3.2%) significant compare with that of normal training phase (P<0.05). RMR(-15.2%), and SMR (-11.8%) significantly decreased during acute weight loss (P<0.05). DIT(-89.4%) tended to be decrease during acute weight loss.[Conclusion] The present study suggests that rapid weight loss in elite male wrestlers causes decreases in RMR and SMR.

The purpose of this study was to investigate differences between underwater and land-based exercise in leg muscle activity. Nine healthy males (mean age : 21.7±0.5 years, mean height : 173.4±2.2 cm) had electrodes placed on their left leg muscles (Tibialis Anterior ; TA, Medial Gastrocnemius ; MG, Soleus ; SOL, Rectus Femoris ; RF, and Biceps Femoris ; BF), and their muscle activity was measured during various exercises. The subjects performed six types of exercise such as the forward walk, backward walk, squat, calf raise, leg range, and one leg wave, both in the water (waist level) and on land. These exercises were categorized as 3 types of leg movement according to direction ; horizontal, vertical, and mixed movement.
In the forward walk and backward walk, categorized as horizontal movements, the integrated electromyogram (IEMG) significantly increased during underwater exercise compared with on land. In the squat, as a vertical movement, the IEMG showed a similar change under both conditions. In the calf raise, as a vertical movement, and leg range and one leg wave, as mixed movements, the IEMG significantly decreased during underwater exercise compared with on land. These results suggest that leg muscle activity during underwater exercise is different based on the movement direction of the legs. In a word, it was apparent that movement in a horizontal direction underwater provides greater activity for leg muscles than on land; but movement in a vertical and/or mixed direction underwater provides less activity for leg muscles than on land. In prescribing an exercise program, it may be helpful to understand the differences between underwater and land-based exercise in leg muscle activity.